Revenue Cycle Specialist

Essential Responsibilities

• Support Accounts Receivable and Cash Applications functions, including:
  • Process insurance and patient payments accurately and in a timely manner.
  • Perform account follow-up on outstanding balances, including insurance claims and patient accounts.
  • Identify and resolve claim issues, denials, and payment discrepancies.
  • Aid in maintaining efficient billing, collections, and cash application workflows.
• Utilize Practice Management Software effectively:
  • Enter, review, and update account and payment information with a high level of accuracy.
  • Identify system or workflow issues and report them to leadership for resolution.
  • Ensure timely claim submission and posting of payments.

Payor and Billing Support

• Maintain and update payor fee schedules as directed.
• Verify reimbursement accuracy and report discrepancies.
• Follow established guidelines for claim submission and documentation requirements.

Performance and Quality

• Meet productivity and accuracy standards for assigned tasks.
• Maintain work queues and ensure timely completion.
• Escalate unresolved issues or trends to the Revenue Cycle Manager.

Team Collaboration

• Communicate effectively with team members and leadership regarding account issues or workflow concerns.
• Participate in team meetings and training sessions.
• Support process improvements and adapt to workflow changes.

Education, Experience, And Certification

• High School Diploma or equivalent required.
• Basic knowledge of healthcare billing, CPT/ICD-10 coding, and claim processes required.
• Proficiency in Microsoft Excel and general computer skills required.
• Prior experience in healthcare revenue cycle, billing, or accounts receivable preferred.
• Understanding of medical terminology and EHR/practice management systems preferred.
• Familiarity with insurance payors and registration data requirements preferred.

Competencies

• Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
• Strong Organizational and Problem-Solving Skills.
• Ability to work independently & as part of a team.
• Professional Communication and Demeanor.
• Strong Attention to Detail and Accuracy.
• Adheres to Confidentiality and Compliance Standards.
• Professional Integrity.

Physical Demands and Work Environment

• Sedentary work requiring prolonged periods of sitting at a computer workstation.
• Regular use of hands and fingers for keyboarding and other standard office equipment.
• Ability to communicate effectively through verbal and written means.
• Ability to hear and understand spoken information in-person and via electronic means.
• Visual acuity to ensure the accuracy of work performed on screens and in documents.
• Ability to maintain focus and attention to detail for extended periods.
• This position is based in a professional office and/or remote office setting that consists of a climate-controlled indoor environment with standard office noise levels that utilizes computers, phones, and related technology.